LAUSR

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Catheter ablation is an effective therapy for recurrent, symptomatic atrial fibrillation (AF). Recent studies proved significantly lower rates of AF recurrence with catheter cryoballoon (CB) ablation compared to antiarrhythmic drug therapy. Purpose To evaluate the feasibility and success rate of CB pulmonary vein isolation (PVI) without pulmonary venography. Methods We enrolled a total of 200 patients undergoing PVI with CB. Among those 101 participants received pulmonary venography shortly after the transseptal puncture and before introducing the cryoballoon (group 1), the rest did not (group 2). Amount of injected radiocontrast, fluoroscopy time and dose, left atrium (LA) dwell time, procedure time and one year’s recurrence rate of AF were registered. Results Fifty five percent of the patients were male. Mean age of participants was 63 years. No significant difference in age, cardiac risk factors or BMI was noted between the two groups. Likewise, no difference was found regarding the procedure time (115 ± 30 minutes in group 2 vs. 116 ± 40 minutes in group 1). Fluoroscopy time was shorter in group 2 (23.9 ± 7 vs. 25 ± 11 minutes, P= 0,003). Fluoroscopy dose was lower in group 2 (579 ± 405 vs. 3310 ± 2408 µGy.m2 , P<0,001). We injected less radiocontrast during PVI in group 2 patients (41 ± 21 vs. 81 ± 31 ml, P<0,001). LA-dwell time was significantly shorter in procedures without venography (71 ± 26 vs. 82 ± 36 minutes, P=0,014). We observed comparable AF recurrence rates in both groups during follow-up (28% group 2 vs. 26% group 1). Four minor complications were noticed in the group 1 while five minor complications occurred in the group 2. Major complications were not elicited in both groups. Conclusion In our center, CB PVI without pulmonary venography was feasible and safe. It resulted in lower fluoroscopy dose and shorter fluoroscopy time. Amount of injected radiocontrast and LA-dwell time were significantly reduced, without an impact on AF recurrence rate or occurrence of procedure-related complications.